Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Jun 2007
Case ReportsThe 'aortic rim' recount: embolization of interatrial septal occluder into the main pulmonary artery bifurcation after atrial septal defect closure.
Percutaneous device closure of atrial septal defect (ASD) has emerged as an alternative to traditional surgical closure. Although reduced hospital stay, decreased morbidity and absence of a surgical incision are beneficial, other procedure- or device-related complications are coming into light. We report a rare complication of early embolization of the Blockaid septal occluder into the main pulmonary artery bifurcation associated with 'aortic rim' erosion and present a brief review of literature pertaining to the high incidence of complications associated with deficient or eroded 'aortic rims' necessitating surgical intervention. ⋯ Strict selection criteria governing an 'adequate' aortic rim, the size of the device, and the choice of the device may help reduce the incidence of complications like the rare, but potentially fatal embolization of the device into the pulmonary artery following percutaneous device closure of an ASD.
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Interact Cardiovasc Thorac Surg · Jun 2007
Comparative StudyComparison of lateral tunnel and extracardiac conduit Fontan procedure.
The purpose of this study was to compare the outcomes of lateral tunnel (LT) and extracardiac conduit (ECC) Fontan procedures at a single institution. From April 1995 to December 2006, 165 Fontan procedures were performed (67 LT, 98 ECC). Pre-, intra- and postoperative variable values were compared between two different techniques. ⋯ Actuarial survival at 10 years is 92% for LT, and 89% for ECC patients (P=0.796). The LT and ECC, both, showed comparable early and mid-term outcomes in operative morbidity and mortality, postoperative hemodynamics, survival. Use of ECC for modified Fontan operation reduces the risk of sinus node dysfunction and shows better outcome of immediate postoperative hemodynamics.
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Interact Cardiovasc Thorac Surg · Apr 2007
Case ReportsPositron emission tomography staging of pleural deposits following Monaldi's procedure: an accurate reflection or a false staging?
Positron emission tomography (PET) has become widely available in staging non-small cell lung cancer (NSCLC) and despite its high accuracy, false positive staging remains a problem. We report a rare case where such false positive staging caused a dilemma in optimal management.